RFP 2023 03 X Ray System Equipment.docx

Request for Proposal

RFP #2023-03

X-Ray System Equipment

ISSUED:

January 23, 2023 at 11:00 am EST

RFP RESPONSES DUE BY:

February 22, 2023 at 2:00 pm EST

MAIL or DELIVER TO:

John Caffelle, Director of Administrative Services Massasoit Community College One Massasoit Blvd.

Brockton, MA, 02302

MASSASOIT COMMUNITY COLLEGE

RFP 2023-03 X-RAY SYSTEM EQUIPMENT

INVITATION

Massasoit Community College, an agency of the Commonwealth of Massachusetts invites proposals from qualified vendors to supply and install new x-ray system equipment and new rails and unistrut at the Brockton Campus for the training of the college’s radiology program students.

Proposals will be received until February 22, 2023 at 2:00 pm EST, when they will be publicly opened and read in the President’s Conference Room, Administration Building, Brockton Campus.

BACKGROUND INFORMATION

Founded in 1966, Massasoit Community College is one of the largest community colleges in Massachusetts. Massasoit offers more than 60+ associate degree and certificate programs across arts, sciences, and applied sciences. With three locations in Brockton, Canton, and Middleborough, Massasoit serves students from all across the metro south region. More than 800 students graduate with an associate degree or certificate each year from Massasoit, and 1,500 students annually enroll in non-credit community education or workforce development courses. Massasoit offers a wide variety of support services to help students develop academic, emotional, and social skills.

PROPOSAL DISTRIBUTION

This Proposal is being distributed electronically using the Commonwealth of Massachusetts online solicitation system COMMBUYS (https://www.commbuys.com). A notice is also being posted on the Commonwealth of Massachusetts Goods and Services Bulletin, in the Brockton Enterprise, on the college’s public records site and in the college’s purchasing area.

Vendors are solely responsible for checking COMMBUYS for any addenda or modifications that are subsequently made to this proposal. The College accepts no liability and will provide no accommodation to vendors who fail to check COMMBUYS after the responses to questions have been posted to ensure that they have the most recent information. Modifications to the body of the proposal, specifications, or that change the intent of this proposal are prohibited and may disqualify a response.

SCHEDULE OF EVENTS

The following is the detailed timeline for this Proposal, Massasoit Community College reserves the right to modify this timeline at its sole discretion.

Site Visit:

The meeting place for the site visit will be the Administration Building Lobby at the Brockton Campus. The site visit is MANDATORY.

January 31, 2023 at 10:00 am EST

Vendor’s Questions Due:

(No questions shall be accepted for this Proposal after February 6, 2023 at 5:00 pm EST to allow the College sufficient time to respond to the questions.)

February 6, 2023 at 5:00 pm EST

QUESTIONS

Vendors may submit written questions or requests for clarification via email to John Caffelle, Director of Administrative Services at jcaffelle1@massasoit.mass.edu on or before February 6, 2023 at 5:00 pm EST. The email subject line should read: “RFP 2023-03 X-Ray System Equipment Questions.” The College will compile all questions and respond via addendum on February 13, 2023 at 5:00 pm EST. Attempts to submit questions via phone or personal contact are not appropriate and will not be answered. Vendors are prohibited from obtaining information about this proposal from any other College personnel. Inquiries received after the specified date and time will not be accepted. The questions and the College’s responses will be issued by formal addendum and posted on COMMBUYS. Vendors are advised to check COMMBUYS throughout the proposal process to ensure they have the most current information.

PROPOSAL SUBMISSION

Proposals will be received until February 22, 2023 at 2:00 pm EST, when they will be publicly opened and read in the President’s Conference Room, Administration Building, Brockton Campus.

Proposals submitted after this date and time will not be considered. Sole responsibility rests with the vendor to ensure that Massasoit Community College receives the vendor’s proposal prior to the Proposal due date and time. Massasoit shall not be responsible for any delays or missed deliveries caused by common carriers. Any risks associated with physical delivery of the proposal are borne by the vendor.

If, at the time of the scheduled opening, the College is closed due to uncontrolled events such as fire, snow, ice, wind, building evacuation or some other unforeseen circumstance, the scheduled opening will be postponed until 2:00 pm EST on the next normal business day. Proposals will be accepted until that date and time.

One (1) original and two (2) hard copies of each proposal shall be submitted along with one (1) electronic copy on a flash drive. The original shall be clearly marked “Original”. The electronic copy shall be submitted in Word or .pdf format. Proposals should be submitted in a sealed envelope and clearly marked on the outside:

RFP #2023-03 X-RAY SYSTEM EQUIPMENT – DO NOT OPEN and mailed or delivered to:

John Caffelle, Director of Administrative Services Massasoit Community College One Massasoit Blvd.

Brockton, MA 02302

FAX AND EMAIL PROPOSAL RESPONSES WILL NOT BE ACCEPTED.

RULE FOR AWARD

The College reserves the right to accept the proposal deemed best value for the Commonwealth of Massachusetts and the College. Best value is the result of common sense procurement decision-making consistent with the Commonwealth’s procurement principles, which are to balance and support the achievement of: required outcomes, best quality economic value, timely performance, minimizing the burdens on administrative resources, expediting simple or routine purchases, flexibility in developing alternative procurement and business relationships, encouraging competition, encouraging the continuing participation of quality contractors and supporting the Commonwealth and the college’s procurement planning and implementation process.

EVALUATION OF PROPOSALS

If a contract is awarded, it will be awarded to the vendor who offers the best value in regards to:

· Pricing

· Experience

· References

SCOPE OF SERVICES

Massasoit Community College is seeking a qualified vendor to supply and install new x-ray system equipment and new rails and unistrut in the Technology Building, Room T436 at the Brockton Campus for the training of the college’s radiology program students. Proposal must include all equipment specified as well as the qualified labor to make the equipment functional. The new x-ray system equipment must meet all industry standards and certifications.

REQUESTED EQUIPMENT

· Features:

· Magnet-actuated parking brakes in longitudinal and transverse direction

· 3 m long transverse track

· Vertical SID acquisition

· Integrated lock function, locks at any position along the ceiling track

· Electromagnetic brake for telescopic lift, transverse track

· Mechanical center-position catch for rotational axis

· Telescope carriage with automatic stop at SID 115cm

· CAN interface

· Cable set 24m for tube and collimator

· Touch user interface for stand and generator control

· Technical Specifications Details:

· Minimum focus-ceiling distance 83 cm

· Vertical telescope travel range 180 cm

· Longitudinal travel range Min. 350 cm/Max 564.5 cm

· Catch positions configurable during installation

· Length transverse track 303 cm/438 cm ± 1 cm

· Tube rotational range horizontal axis -120°/+120°

· Catch positions -90°, 0° and +90°

· Front touch user interface SID, Horizontal tube rotation angle, generator control

· Manual collimator with 6 pairs of blades

· Accessory rails (cones, filters, etc.)

· Field light lamp (light of the lamp 160 lux)

· Light indicator for alignment with the bucky

· Lamp timing – Retractable measuring tape

· SV 150/40/80-100

· Nominal Voltage 150 kV

· Anode Angle 12°

· Focal Spot/Size 0.6/1.0

· Anode heat storage capacity 450 kJ (600 kHU)

· Tube housing heat storage capacity 1800 kJ (2430 kHU)

· Maximum anode heat dissipation 2000 W

· Four-ways floating table top with electromagnetic brakes

· Table top dimensions 86.6” length by 30.9” wide

· Flat composite Carbon Fibre table top to increase patient comfort and reduce x-ray dose (0.026” Al at 100 Kvp)

· Patient loading capacity 660 lbs.

Table top movement:

· Longitudinal 43.1” (+23.6”, -19.5”)

· Transversal 9.8” (4.9”)

· Vertical 13.8”

· Minimum floor-table distance 21.6”

· Maximum floor-table distance 35.4”

· Longitudinal detector travel 24”

· Prepared for Flat Panel Detector

Claymount Enclosure

Rotating Table Claymount Enclosure

17-1/4” x 18 7/8” 8:1/215/34-44

Otterbox for wireless panel included

AEC

· Control of the Automatic Exposure Control for quantity one, 3-field Ion Chamber, and AEC Generator Control Board

· Operating mode: 0, 2 or 4 points

· Zero point with anatomical program APR. Automatic selection of the programmed radiographic parameters (kVp, mAs, working station, AEC, Focal Spot, according with patient size and anatomical area selected)

· Two points: kVp and mAs

· Three points: kVp, mA and time

Pre-amplifier for measuring chamber

Grid cap for table work

Wireless Panel Weight Distribution Cap

Table Side Control for NET 4000 Table

Left Hand Non-Tilting Wall Stand with Rotating Configuration Left Hand Load Rotating Non-Tilting Wall Stand

· Heavy duty vertical bucky stand providing full flexibility for radiographic examinations:

· Non-Tilting Wall Stand

· Vertical travel 59”

· Minimum floor distance 15.7”

· Maximum floor distance 74.8”

· Fully counterbalanced for manual positioning

· Adaptations for Digital Flat Panel instead of standard bucky

Rotating Left Hand Claymount Enclosure Included

17-1/4” x 18 – 7/8” 8:1/215/40-72

AEC

· Control of the Automatic Exposure Control for quantity one, 3-field Ion Chamber, and AEC Generator Control Board

· Operating mode: 0, 2 or 4 points

· Zero point with anatomical program APR. Automatic selection of the programmed radiographic parameters (kVp, mAs, working station, AEC, Focal Spot, according with patient size and anatomical area selected)

· Two points: kVp and mAs

· Three points: kVP, mA and time

Pre-amplifier for measuring chamber

208/240 VAC, High Speed Generator

SHFR 50kw 208/240 VAC, High Speed Generator 150kvp 3 Phase High Frequency Generator SHF525 50kW/150kV Anatomical Program Microprocessor Controlled

· High Frequency 25KHz, 1 tube operation

· 3 Phase 208/240 VAC

· Output power:

640 mA @ 78kVp 500 mA @ 100kVp 400 mA @ 125kVp 320 mA @150 kVp

· Automatic line compensation +/-10%

· Microprocessor controlled with auto diagnostic and error code indication for easy maintenance

· X-ray tube overload protection

· X-ray tube H.U. available indication and continuous monitoring for x-ray tube protection

· Control of x-ray tube number of exposures

· Hand switch for preparation and exposure control

· Light and sound indication for x-ray exposure

· kVp Radiographic range from 40 to 125 kVp in 1 kVp step

· mA Radiographic range from 10 to 640mA in 19 steps

· Renard scale 10, 12.5, 16, 20, 25,32,40, 50, 64, 80, 100, 125, 160, 200, 250, 320, 400, 600 and 640 mA

· mAs range from 0.1 to 500 mAs in 38 steps, Renard scale

· Exposure time range from 0.001 to 10 seconds

· High Speed Starter included

with monitor

Ultra Software Upgrade with monitor

· Dell OptiPlex XE3 Small Form Factor PC

· Windows 10 loT Enterprise

· Intel Core l7-8700 Processor (6 Cores,/12MB/12T/up to 4.6GHz/65W)

· 8GB Ram

· DVD/CD RW Drive

· 24” Touchscreen monitor

· Resolution 1280 x 1024; 8000:1 Ratio

· Automatic setting of acquisition parameters according to body part and system specified programmable APRs (Anatomically Programmed Radiography)

· One console operation – generator parameters setting by the workstation as part of APR

· Patient data entry, manually or automatically from the DICOM worklist (MWL optional)

· Urgent patient registration

· Preview image typically within 4-5 seconds after exposure

· Exam specific image processing for optimized image quality

· Automatic backup of operator accepted images

· Patient review

· CD Burning

· Exam foldering

· Ability to add body part or view during an exam

· Touch screen post processing

· Assign single or multiple technologist(s) to an exam

· Add additional views and/or studies to a completed exam

· Ability to suspend an exam

· Built-in technique and positioning chart

· Variable image rotation

· Window/Level, Reverse Black/White (Window polarity inversion)

· Electronic zoom with pan and scroll capabilities

· Touchscreen zoom, pan, window/level and contrast capability

· Magnifying glass

· Multi-scale contrast enhancement and Dynamic Range

· Electronic shutter for masking of image (cropping)

· Multiformat display (for printing)

Applications Training

· Up to 3 days of onsite DR Applications Training

· Vendor shall be responsible for the removal and the proper disposal of one x-ray unit and the relocation and de-energizing of the other x-ray unit in Room T436 based on the functional remaining life span of the two units

· Vendor shall provide and install new longitudinal rails

· Vendor to furnish and install support members and hardware for the installation of ceiling mounted equipment

· Vendor rails to be fastened to unistrut rails

· Vendor shall furnish and install ceiling unistrut and hardware above ceiling. Bottom of unistrut flush with ceiling. Minimum of seven (7) unistrut supports.

· Vendor to provide structural PE stamped drawing

· All unistrut member spaces to be coordinated with x-ray vendor

· Above ceiling unistrut to have main vertical supports anchored to concrete deck as required to support x-ray equipment. Diagonal braces to be included with each vertical support.

See Exhibit A: Photographs of Ceiling Area in Room T436

PLEASE NOTE THAT ALL EQUIPMENT MUST BE INSTALLED AND FULLY OPERATIONAL ON OR BEFORE JUNE 30, 2023

PREVAILING WAGE RATES

The Awarded Contract will be subject to prevailing wage rates. A copy of the Massachusetts Department of Labor and Workforce Development, Department of Labor Standards prevailing wage rates are posted on COMMBUYS. Labor rates for functions not covered under prevailing wage laws, must, at a minimum, meet and include the minimum wage rates established by the Massachusetts Department of Labor.

INDEMNIFICATION

The Vendor shall defend, protect, and indemnify the Commonwealth of Massachusetts, the Department of Higher Education, the College, its Board of Trustees, and their employees and agents from and against all claims, suits, and actions arising from any act or omission of the vendor, or any of its employees, agents, or authorized sub-vendors, in the performance of its obligations under this contract.

INSURANCE REQUIREMENTS

The Vendor agrees to furnish worker’s compensation and employer’s liability insurance covering all persons employed by the vendor who are engaged in the performance of the services rendered to the College. The vendor shall include a provision that there will be no right of subrogation against the College in the event of a worker’s compensation or liability insurance payment.

The Vendor shall have and maintain without deductibility, Vendor’s Public Liability and Property Insurance and Vendor’s Protective Liability, Protective Property Damage Liability Insurance and Comprehensive Automobile Liability in the following suggested amounts:

Worker’s Compensation

Worker’s compensation must include and cover working executives and owner/operators.

Comprehensive General Liability

1. Bodily Injury

2. Property Damage

Contractual Liability

1. Bodily Injury

a. Each Occurrence $1,000,000

2. Property Damage

Personal Injury with Employment Exclusion deleted

1. Annual Aggregate $1,000,000 Comprehensive Automobile Liability

1. Bodily Injury

2. Property Damage

Each certificate or instrument shall contain a valid provision of endorsement that the policy may not be cancelled, terminated, changed or modified without giving thirty (30) days written notice thereof to the College and that the insurance company waives their right to subrogation and indemnification against the College and the Commonwealth of Massachusetts.

All insurance policies shall name the College as an “Additional Insured”.

All insurance policies required herein shall contain the following provision or its equivalent with the same meaning and intent:

“The insurance company waives any right of subrogation and indemnification against Massasoit Community College, its trustees, officers, employees or their agents, or the Commonwealth of Massachusetts which may arise by reason of any payments under this policy.”

PROPOSAL TERMS AND CONDITIONS

ACQUISITION METHOD

Outright purchase.

SINGLE OR MULTIPLE CONTRACTORS

Single.

USE BY SINGLE OR MULTIPLE DEPARTMENTS

The Award of this proposal will be for Massasoit Community College only. Massachusetts state higher education institutions have the option to use this competitively proposal contract.

Massasoit Community College will have no responsibility for other agency agreements or payments.

PERIOD OF FIRM PROPOSAL

Proposals must remain in effect for a period of 120 calendar days after the proposal deadline date in order to allow Massasoit Community College sufficient time for evaluation, approval, and issuance of award notice. No proposal shall be subject to correction or amendment for any error or miscalculation unless authorized by Massasoit Community College.

GENERAL INFORMATION

All terms, conditions, requirements, and procedures included in this RFP must be met for a proposal to be determined responsive. If a vendor fails to meet any material term, condition, requirement, or procedure, its proposal may be deemed unresponsive and disqualified.

ACCEPTANCE/REJECTION OF PROPOSAL

Massasoit Community College reserves the right to reject any or all proposals, wholly or in part;

to waive technicalities, irregularities, and omissions and to correct any award erroneously made as a result of a clerical error on the part of the College. Only proposals that are received by the proposal opening date and time and at the designated location will be considered. Fax and email proposal responses will not be accepted.

WITHDRAWAL OF PROPOSAL

Proposals may be withdrawn at any time prior to the proposal deadline date and time. Once the proposal deadline has passed all proposals become the property of Massasoit Community College.

RFP CANCELLATION

Massasoit Community College reserves the right to cancel this proposal at any time before a contract has been executed and approved, in which event the College will reject any and all proposals received in response to this RFP. Should the proposal be cancelled, all expenses related to preparation of response to this RFP remain the responsibility of the vendor.

PROPOSAL MATERIALS

All materials submitted in response to the RFP shall become the property of Massasoit Community College upon submission and will be considered as part of this RFP.

PROPOSAL EXPENSES

Any and all costs associated with the preparation and submission of the proposal will be at the sole expense of the vendor. Massasoit Community College will not pay for any information requested under this RFP, nor is it liable for any costs incurred by the vendor responding to this RFP.

NO JOINT VENTURE

It is expressly agreed and understood that the Contract, if awarded shall not be deemed or construed so as to create a joint venture, partnership, agency or employer-employee relationship, or make Massasoit Community College in any way responsible for the past, current or future debts, fees and/or losses of the vendor.

EMPLOYEES

All workers performing services shall be employees of the vendor and shall not under any circumstances be considered employees of Massasoit Community College. The vendor shall provide and be responsible for all required services and benefits to its employees, including worker’s compensation and unemployment insurance.

FORCE MAJEURE

The parties agree that, if by reason of strike or other labor disputes, civil disorders, inclement weather, pandemics, acts of God or other unavoidable cause, either party is unable to entirely perform its obligations, such non-performance shall not be considered a breach of the Contract.

ASSIGNMENT

Vendor shall not assign or subcontract, in whole or in part, its rights or obligations under the Contract, without prior consent of Massasoit Community College. Any attempted assignment without said consent, shall be void and of no effect.

CHANGES

The Contract, if awarded, shall not be modified, altered or changed except by mutual agreement confirmation in writing by an authorized representative of each party to the Contract.

MASSACHUSETTS PUBLIC RECORDS LAW

All material submitted by the vendor becomes the property of the Commonwealth of Massachusetts and will not be returned to the vendor. All responses and information submitted in response to this RFP are subject to Massachusetts Public Law, M.G.L., Chapter 66, Section 10, and to Chapter 4, Section 7, Subsection 26, regarding public access to such documents. Any statements reserving any confidentiality or privacy rights in submitted proposals or otherwise inconsistent with these statutes will be void and disregarded.

CONFIDENTIAL INFORMATION

During the performance of the Contract, the vendor may have access to sensitive and/or confidential information, the privacy of which is legally protected or the disclosure of which is legally prohibited. The vendor will be required to keep such information confidential to the fullest extent provided by state or federal law.

INTERPRETATION

Interpretation of the wording of this document shall be the responsibility of Massasoit Community College and that interpretation shall be final.

COMPLIANCE TO LAW

The Contract, if awarded, shall be governed and construed in accordance with the laws of the Commonwealth of Massachusetts. It is understood that Massasoit Community College is a state institution and derives its operating funds from annual appropriations by the Legislature of the Commonwealth of Massachusetts. Multiple year contracts are subject to annual appropriation of funds.

Vendors must comply with Affirmative Action/Equal Opportunity Regulations. All applicable rules and laws of the Commonwealth apply.

All Vendors and their employees must be aware of and comply with the requirements of the Commonwealth of Massachusetts Conflict of Interest Law, and all other appropriate provisions of the Commonwealth of Massachusetts Law and resultant codes, rules, and regulations from Commonwealth laws establishing the standards for business with the Commonwealth. In signing the Proposal, each vendor guarantees knowledge and full compliance with those provisions for any dealings, transactions, sales contracts, services, offers, relationships, etc. involving the Commonwealth and/or Commonwealth employees. Failure to comply with those provisions may result in disqualification from the proposal process and in other civil or criminal proceedings as required by law.

All Vendors and their employees are expected to abide by the College’s alcohol and drug policy. The policy can be found at the following link:https://massasoit.edu/about/college-policies/alcohol-and-drug-policy/

For information regarding the policy of fire arms on campus, Vendor should refer to Massachusetts General Laws Chapter 269, Section 10(j).

Non-Discrimination in Employment: The Vendor shall not discriminate against any qualified employee or applicant for employment because of race, color, national origin, age, sex, sexual orientation, gender identity, religion, genetic information, maternity leave, military service, marital status or disability. The Vendor agrees to comply with applicable federal and state statutes, rules and regulations prohibiting discrimination in employment, including Title VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act of 1967, Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990, Massachusetts General Laws, Chapter 151B and all administrative and executive orders, where applicable.

DEBARMENT

The Vendor certifies, to the best of their knowledge and belief, that the company and its principals: are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal or state department or agency; have not within a three (3) year period preceding the Contract been convicted of, or had a civil judgment rendered against them from commission of fraud, or a criminal offense in connection with obtaining or attempting to obtain, or performing a public (federal, state or local) transaction or grant under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification, or destruction of records, making false statements, or receiving stolen property; are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses listed above; and have not within a three (3) year period preceding this Contract had one or more public transactions (federal, state or local) terminated for cause or default.

TAXES

No charge will be allowed for federal, state, property or municipal sales or excise taxes, from which Massasoit Community College is exempt by law. The proposal price shall be net and shall not include the amount of any such tax. Exemption certificates, if required, will be furnished on forms provided by Massasoit Community College.

PERMITS AND LICENSES

The Vendor shall, at its sole expense, procure and keep in effect, all permits and licenses required to conform with any city, state and federal statutes, regulations and/or finances for this type of Contract, and shall post or display, in a prominent place, such permits and/or notices as are required by law.

COVID-19 VACCINATION REQUIREMENTS

Effective January 3, 2022 Massasoit Community College has implemented COVID-19 Vaccine Policy of the Massachusetts Community College System for Employees (“Policy”) which also addresses vendors, consultants and business invitees (“contractors”). For those vendors determined by the College to have a regular presence on campus and/or routinely interact with students and/or employees, the College will require those vendors to be fully vaccinated in compliance with the Policy. Unless otherwise determined by the College, vendors that are not regularly on campus and/or who do not routinely interact with students and/or employees will not be required to be fully vaccinated in compliance with the Policy, but will be required to comply with health and safety protocols as established by the College.

As a Vendor your compliance with pandemic-related federal, state and local public health orders and CDC guidance as well as all applicable college policies, including the COVID-19 Vaccine Policy of the Massachusetts Community College System for Employees (“Policy”). The Vendor hereby certifies that anyone assigned or dispatched to work onsite at the College as of January 3, 2022 shall comply with the following health and safety protocols as determined by the College in consideration of local or state public health or DCD guidance, mandates and/or guidance at: https://massasoit.edu/covid-19-related-information-2/.

REQUIRED FORMS

Following this page are all of the required forms that must be submitted with the vendor’s proposal materials in order to be considered a responsible and responsive bidder.

1. Commonwealth of Massachusetts - Contractor Authorized Signatory Listing

2. Vendor Information Form

3. Certificate of Compliance with State Tax Laws and with Unemployment Compensation Contribution Requirements

4. Certificate of Non-Collusion

5. Reference Form

6. Pricing Form

VENDOR INFORMATION FORM

(Vendor must have a minimum of 5 years of experience in the x-ray system equipment industry)

Vendor’s Company Name:

Headquarters Address:

Incorporation Status:

Years of Operation:

Chief Executive Name/Title:

Phone:

Email:

Lead Point of Contact for Proposal Name/Title:

Phone:

Email:

______: I have received and reviewed all of the Proposal information and attachments in this RFP.

· The above-named organization is the legal entity entering into the resulting contract with the College if they are awarded the contract.

· The undersigned is authorized to enter contractual obligations on behalf of the above-named organization.

· Vendor acknowledges that there are no past or pending legal actions including contract defaults, litigation and bankruptcy, and/or any purposeful business name change due to contract defaults, litigation or bankruptcy.

Name (Print):

Title:

Authorized Signature:

Date:

CERTIFICATE OF COMPLIANCE WITH STATE TAX LAWS AND

WITH UNEMPLOYMENT COMPENSATION CONTRIBUTION REQUIREMENTS

Pursuant to M.G.L., Ch. 62C, s. 49A and M.G.L., Ch. 151A, s. 19A, I, ________________________________________________ authorized signatory for ________________________________ whose principal place of business is at _______________________________________________________ do hereby certify under penalties of perjury that ___________________________________ has filed all state tax returns and paid all taxes as required by law and has complied with all state laws pertaining to contributions to the unemployment compensation fund and to payments in lieu of contributions.

The Business Organization Social Security Number or Federal Identification Number is ________________________.

Signed under the penalties of perjury the __________ day of ______________ 20 ____.

Signature: ____________________________________________ Name and Title: ________________________________________

CERTIFICATE OF NON-COLLUSION

The undersigned certifies under penalties of perjury that this Proposal or Proposal has been made and submitted in good faith and without collusion or fraud with any other person. As used in this certification, the word “person” shall mean any natural person, business, partnership, corporation, union, committee, club or other organization, entity, or group of individuals.

Signature of individual submitting Proposal or Proposal

Name of business

REFERENCE FORM

Three references are required from higher education institutions or healthcare facilities that you have provided similar equipment for in the past three (3) years. References will be checked. Note: Poor references may be a basis for a determination that the vendor is not a responsible bidder.

Reference 1 Higher Education Institution or Healthcare Facility Reference Name:

Address:

Contact:

Email:

Phone:

Description and dates of services provided:

Reference 2 Higher Education Institution or Healthcare Facility Reference Name:

Address:

Contact:

Email:

Phone:

Description and dates of services provided:

Reference 3 Higher Education Institution or Healthcare Facility Reference Name:

Address:

Contact:

Email:

Phone:

Description and dates of services provided:

PRICING FORM

Amount

Removal and the proper disposal of one x-ray unit and the relocation and de-energizing of the other x-ray unit in Room T436 based on the functional remaining life span of the two units as described in the Requested Section of the RFP

New rails and unistrut as described in the Requested Equipment section of the RFP

In addition to the above, pricing should include the following:

Delivery, Freight, Set-up, Installation, Testing, Training and Software

PLEASE NOTE THAT ALL EQUIPMENT MUST BE INSTALLED AND FULLY OPERATIONAL ON OR BEFORE JUNE 30, 2023

Additional Charges, if any (Please specify)

Lead Time for the Requested Equipment

Authorized Signature

Name Printed:

Date:

Company:

Email:

Phone:

Fax:

SUBMISSION CHECKLIST

REQUIRED SUBMISSIONS

_____ Vendor’s Proposal, include all specifics of your proposal submission. The new x-ray system equipment must meet all industry standards and certification.

One (1) original and two (2) hard copies along with one (1) electronic copy on a flash drive.

_____ Commonwealth of Massachusetts – Contractor Authorized Signatory Listing, one (1) original

_____ Vendor Information Form, one (1) original

_____ Certificate of Compliance with State Tax Laws and with Unemployment Compensation Contribution Requirements, one (1) original

_____ Certificate of Non-Collusion, one (1) original

_____ Reference Form, one (1) original

_____ Pricing Form, one (1) original

The awarded vendor will be required to sign/acknowledge and submit the following forms within ten (10) days of the date of award.

Mass W-9 Form

Certification of Liability Insurance

COVID-19 Compliance Statement

Commonwealth of Massachusetts – Standard Contract Form and Standard Contract Form Instructions (dated 7/22/21) can be reviewed at the following link:

https://www.mass.gov/lists/osd-forms

Please note that any changes to this document may result in a vendor being considered non-responsive and disqualified from the process.

Commonwealth of Massachusetts – Terms and Conditions (dated 10/25/19) can be reviewed at the following link:

https://www.mass.gov/lists/osd-forms

Please note that any changes to this document may result in a vendor being considered non-responsive and disqualified from the process.

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